The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system.

At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year.

Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles -- including limits on nurses' scope of practice -- should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care.

In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.

Contents

• THE NATIONAL ACADEMIES
• COMMITTEE ON THE ROBERT WOOD JOHNSON FOUNDATION INITIATIVE ON THE FUTURE OF NURSING, AT THE INSTITUTE OF MEDICINE
• Reviewers
• Foreword
• Preface
• Acknowledgments
• Acronyms and Abbreviations
• Summary
• Overview of the Report
• Part I. Key Messages and Study Context
  • 1. Key Messages of the Report
    • A VISION FOR HEALTH CARE
    • THE ROLE OF NURSES IN REALIZING THIS VISION
    • THE NEED FOR A FUNDAMENTAL TRANSFORMATION OF THE NURSING PROFESSION
    • CONCLUSION
    • REFERENCES
    • ANNEX 1-1 KEY TERMS AND FACTS ABOUT THE NURSING WORKFORCE
  • 2. Study Context
    • EVOLVING HEALTH CARE CHALLENGES
    • PRIMARY CONCERNS IN HEALTH CARE REFORM: QUALITY, ACCESS, AND VALUE
    • PRINCIPLES FOR CHANGE
    • CONCLUSION
    • REFERENCES
• Part II. A Fundamental Transformation of the Nursing Profession
  • 3. Transforming Practice
    • THE IMPORTANCE OF TRANSFORMING NURSING PRACTICE TO IMPROVE CARE
    • BARRIERS TO TRANSFORMING PRACTICE
    • NEW STRUCTURES, NEW OPPORTUNITIES
    • CONCLUSION
    • REFERENCES
    • ANNEX 3-1 STATE PRACTICE REGULATIONS FOR NURSE PRACTITIONERS
  • 4. Transforming Education
    • UNDERGRADUATE EDUCATION
    • GRADUATE NURSING EDUCATION
    • COMPETENCY-BASED EDUCATION
    • THE NEED TO INCREASE THE DIVERSITY OF THE NURSING WORKFORCE
    • SOLUTIONS FROM THE FIELD
    • CONCLUSION
    • REFERENCES
  • 5. Transforming Leadership
    • A NEW STYLE OF LEADERSHIP
    • A CALL FOR NURSES TO LEAD
    • ANSWERING THE CALL
    • A CALL FOR NEW PARTNERSHIPS
    • CONCLUSION
    • REFERENCES
  • 6. Meeting the Need for Better Data on the Health Care Workforce
    • CURRENT ESTIMATES OF PRIMARY CARE PROVIDERS AND NURSES
    • GAPS IN CURRENT WORKFORCE DATA
    • GULF COAST HEALTH SERVICES STEERING COMMITTEE
    • CONCLUSION
    • REFERENCES
• Part III. A Blueprint for Action
  • 7. Recommendations and Research Priorities
    • CONSIDERATIONS THAT INFORMED THE COMMITTEE’S RECOMMENDATIONS
    • CONCLUSION
    • RECOMMENDATIONS
    • REFERENCES
• Appendixes
  • A Methods and Information Sources
  • B Committee Biographical Sketches
  • C Highlights from the Forums on the Future of Nursing
  • D APRN Consensus Model
  • E Undergraduate Nursing Education
  • F Health Care System Reform and the Nursing Workforce: Matching Nursing Practice and Skills to Future Needs, Not Past Demands
  • G Transformational Models of Nursing Across Different Care Settings
  • H Federal Options for Maximizing the Value of Advanced Practice Nurses in Providing Quality, Cost-Effective Health Care
  • I The Future of Nursing Education
  • J International Models of Nursing

This study was supported by Contract No. 65815 between the National Academy of Sciences and the Robert Wood Johnson Foundation. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

Suggested citation:

IOM (Institute of Medicine). 2011. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.